Abstract: Objective To observe the efficacy of antiviral therapy with nucleos（t）ide analogs in patients with hepatitis B acute-on-chronic liver failure （ACLF）. Methods A total of 178 patients with ACLF induced by hepatitis B viral infection were divided into antiviral group（n=115） and control group（n=63）. The patients in antiviral group were given nucleos（t）ide analogs at the base of symptomatic and supporting treatment, and in the control group were not given antiviral therapy. Serum HBV DNA was assayed by PCR,and the model of end-stage liver disease（MELD） was calculated. Results At the end of 24 weeks observation,the survival rate in the antiviral group was 65.2%,much higher than in the control group（39.7%,P<0.05）;the white blood cell counts,neutrophils,platelets,hemoglobin and fibrinogen levels in survival patients receiving antiviral treatment were（7.2±1.6）×10⁹/L,（5.1±2.7） ×10⁹/L,（131.4±50.3）×10⁹/L,（143.7±14.5） g/L and（2.0±0.6） g/L,much higher than those in control group [（4.4±3.6）×10⁹/L,（2.6±3.3）×10⁹/L,（96.2±53.3）×10⁹/L,（116.5±24.4） g/L and （1.3±0.5）g/L,P<0.01]; the prothrombin time and international normalized ratio in antiviral group were（15.5±4.4） s and（1.3±0.5）,respectively,significantly lower than those in control group[（24.2±10.2） s and（2.0±1.5）,P<0.01]. Conclusion Antiviral therapy can improve the coagulation function index,peripheral blood cell counts,and the survival rate of patients with ACLF.

Key words: Acute-on-chronic liver failure, Hepatitis B, Nucleos（t）ide analogs, Survival